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Risk of Moderate to Severe Ocular Surface Disease Associated with Epidermal Growth Factor Receptor Tyrosine Kinase

Yu-Ting Tsao1, Eugene Yu-Chuan Kang1,2,3,4, Chiao-En Wu2,5

  • 1Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan.

Ophthalmology and Therapy
|July 17, 2025
PubMed
Abstract

Insights

Patients receiving EGFR-TKI therapy for lung cancer face risks of moderate to severe ocular surface disease (OSD). Key risk factors include female sex, prior ocular surgery, older age, autoimmune disease, peptic ulcer, thyroid disease, and systemic steroid use.

Area of Science:

  • Ophthalmology
  • Oncology
  • Medical Research

Background:

  • Epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) therapy is crucial for lung cancer treatment.
  • Moderate to severe ocular surface disease (OSD) significantly impacts patients' quality of life during EGFR-TKI therapy.
  • Identifying risk factors for OSD in this patient population is essential for proactive management.

Purpose of the Study:

  • To investigate the key risk factors associated with moderate to severe ocular surface disease (OSD) in lung cancer patients undergoing EGFR-TKI therapy.
  • To identify specific risk factors contributing to the development of severe OSD.

Main Methods:

  • A multicenter retrospective cohort study was conducted from November 2004 to December 2019.
  • Included 31,491 patients with lung cancer, with a focus on 6,677 eligible patients receiving EGFR-TKI therapy.
  • Moderate to severe OSD was defined by specific clinical criteria, and risk factors were analyzed using univariate and multivariate Cox proportional hazards models.

Main Results:

  • 3.3% of patients (220 out of 6,677) developed moderate to severe OSD.
  • Independent risk factors for moderate to severe OSD included female sex, prior ocular surgery, older age, autoimmune disease, peptic ulcer, thyroid disease, and systemic steroid use.
  • Specific risk factors for severe OSD included distant metastasis, prior radiotherapy, thyroid disease, and high Charlson Comorbidity Index scores.

Conclusions:

  • Patients with identified risk factors are at higher risk of developing moderate to severe OSD during EGFR-TKI therapy.
  • Early identification and intervention by ophthalmologists and oncologists are crucial for high-risk individuals.
  • Timely management can potentially mitigate disease progression and improve patient quality of life.
Keywords:
ConjunctivitisCorneal ulcerDry eye diseaseEpidermal growth factor receptor inhibitorKeratitisLung neoplasmsOcular surface diseaseTyrosine kinase inhibitor

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